| NPI | 1437535374 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YA00090900) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ 25MG00136500) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |